A domestic helper is engaged under a household employment permit, and that permit covers domestic work: cleaning, cooking, laundry, general household help. Nursing care for a person with clinical needs sits outside it. Many families discover this only when something goes wrong.

The practical dividing line

The third category needs a trained carer or a nurse, and often an agency with a supervising clinician. Asking an untrained helper to manage a catheter or oxygen concentrator is not just a compliance issue — it is the situation where avoidable harm happens, and where insurance and liability become very unclear.

What good agencies do differently

  • Name the supervisor who is contactable outside office hours
  • Provide a written care plan reviewed at fixed intervals
  • Document what the aide is trained to do and what triggers a nurse visit
  • Replace staff during leave rather than leaving cover to the family
  • Carry insurance that covers the aide, the client and the premises

Ask for all five in writing before signing. An agency that hesitates on any of them is telling you something useful before you have paid a deposit.

Questions readers ask

Can our helper give my father his medication?
Prompting and reminding is normal household support, and with a written care plan it is usually fine. What sits outside the permit is anything clinical: adjusting a dose, crushing tablets that are not meant to be crushed, giving injections, or managing a catheter. Those need a trained carer or a nurse, and an agency that says otherwise is putting your parent at risk.
What happens if the aide is injured in our home?
Ask the agency, in writing, who is insured and for what — the aide, the client and the premises are three separate covers. If you employ someone directly rather than through an agency, the responsibility may sit with you, so get this confirmed before the first day rather than after an incident.

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